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Best Treatment For These Scars (Pics)

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Hello, background of my experience so far. I am 20 years old and only got severe acne randomly less than a year ago when I was 19. I went to a GP and she put me on antibiotics (doxycycline) and said if it doesn't improve she would refer me to a dermatologist. About a week later I decided to go back to the doctors and try to push to see a dermatologist, this time my appointment was with a different GP who agreed for me to see a dermatologist, as I am in the UK there is quite a long waiting list for the NHS, so the doctor told me to keep taking the antibiotics and use isotrex until my appointment with the dermatologist. By the time of my first appointment with the dermatologist, there wasn't much active acne, however my face was still very greasy and had lots of very dark marks all over my temples and forehead. The dermatologist put me on a course of accutane for 3 months,60 mg a day. I had another appointment after 6 weeks just a routine, for blood tests etc. and today I went back as the 3 months is over. Today he decided to keep me on accutane at 60 mg for 1 more month. I know to wait 6 months after finishing your accutane course before doing any skin resurfacing procedures but I want to plan in advance and know what is my best option.

My Scars

My scars are on my temples and look shallow however in some different lightings they can look absolutely terrible and I've searched online and on this site for months to find out what the best options are.

Left side bad lighting post-218448-0-73096600-1378825995.jpg

Left side good lighting post-218448-0-76680200-1378826134.jpg

right side bad lighting (taken in mirror thats why it looks like left side of face) post-218448-0-81971000-1378826780.jpg

right side good lighting post-218448-0-48179100-1378826799.jpg

Please can someone get back to me and tell me what are the best options for these types of scars.

thanks.

post-218448-0-73096600-1378825995.jpg

post-218448-0-76680200-1378826134.jpg

post-218448-0-81971000-1378826780.jpg

post-218448-0-48179100-1378826799.jpg

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Dermal fillers would be a quick fix if you're concerned about getting results, but have to be maintained routinely. Seeing that they are shallow scars, possibly rolling, I would probably go the fractional CO2 laser path; one session should probably give decent results.

They do not look severe enough for subcision, however.

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thanks for the reply NUman. I hate looking at them in some lightings and it really stresses me out, like in windows, bad lighting and when driving looking into the mirrors are when they look bad, whereas other times i dont feel as bad about them! Got to get this last month of accutane out of the way first anyway, then the 6 that follow!

edit: do they look more like rolling scars or boxcar scars to you?

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Were the scars on your temple quite red before? They seem to match your skin tone now. I have similar scarring on my temples but mine are still pretty red (I'm almost 3 months into accutane).

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For me, boxcar scars are those with jagged edges (suddenly dipping) while rolling have smooth edges that dips slowly. Yours look very much like rolling scars to me and shallow ones at that.

I'm currently about a month out from fractional CO2 laser myself using the CO2RE laser, and I only have a few rolling scars so I could pinpoint and observe their progress properly. All I have to say so far is that they show significantly more improvement than icepick or boxcar scarring, most of them I barely even notice now. With that, I would say if your dermatologist identify your scarring as rolling, I'd say you have a good chance to see decent improvement. Bear in mind, none of this is a quick fix and even I only seen minor results after 2 weeks out.

If you live in Canada, I would also suggest you browse airgent/enerjet treatments as well, since it injects derma fillers into your skin while you heal to provide some initial cosmetic gratification and some acne.org members have seen improvement with the treatment.

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You probably don't think so, but you are lucky that your scars are in the location they are. You should respond nicely to Re:pair at high intensity and multiple treatements.

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You probably don't think so, but you are lucky that your scars are in the location they are. You should respond nicely to Re:pair at high intensity and multiple treatements.

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My experience has been that areas supported by bone are easier to treat.

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My experience has been that areas supported by bone are easier to treat.

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Some look like ice pick scars to me. I think you would be a good candidate for TCA cross.

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Acne scars were a side use of Re:pair. It was intended for the cosmetic industry for skin tightening. Negative responders will always outnumber the pro-laser crowd. Once you achieve results there is little reason to hang around. From my experience most of the naysayers have no real experience with Re:pair, and are merely responding to hearsay. They will often sidetrack people with their rhetoric and introduce voodoo cures.

My experience has been that areas supported by bone are easier to treat.

Hey dudley,

I always see your posts prasing lasers.

I am quite curious though. I read a lot of dissatisfied patients who had orange peel texture, large pores, fat loss, hyperpigmentation, hypopigmentation, etc. as a result of laser surgery. There are more horror stories than the good ones.

I would like to know your insight about this.

Also, woudnt lasering unscareed skin make it worse?

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I agree with Dudley

I agree their are risks but the ones who are unhappy speak the LOUDEST.

I read may posts about the dangers of IPL and decided to take the risks to treat my sun damage and Im glad I did it.

You have to make sure that you are a right candidate, and that with any procedure their are risks and then decide if its worth it for you.

What I have realized is to stop reading the good and bad reviews, ask as many questions with your dr, make sure you pick a good dr. and then decide:)

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DudleyDoRight and luvskincare13:

While I appreciate your shared sentiment that people with negative experiences with acne-related procedures will be "louder" than those who have had a positive experience, I think you're both too quick to discount the very real risk and the very uncertain promise that lasers have to offer when it comes to treating acne scarring.

I have moderate to severe scars (rolling and ice pick primarily) on both temples that has plagued me for the last 5 or 6 years. I sought treatment with one of the most reputable licensed dermatologists in my state, did research, had realistic expectations; yet post-treatment my scars have only gradually gotten significantly worse.

I participated in several sessions of treatment with several months in between each session. My final laser treatment session was close to 3 years ago. Parts of my temple that previously displayed no signs of scarring whatsoever are now very noticeably scarred.

What are you really doing when you use "Fraxel Lasers"? You're essentially incinerating skin (at various chosen depths depending on the intensity and width of the laser) in hopes that the skin will build anew and restored, yea? Yes, that is what you're doing.

Well... you and I know that anytime skin is removed there's no guarantees on how it's going to rebuild. Dermatologist can guess, but it's just a guess. What is extremely likely though is that you're just going to end up replacing an old scar with a new scar (and many times--in both my experience and my observation--the new scar is worse than the old one).

I think part of the appeal of laser treatment is the fact that it requires a magical term that few really understand like "laser". Why not give lightsabers or magical wands a shot? Dermatologists can charge an extra couple grand for that level of treatment! I'm sure there's a market! Because unfortunately I know that there are thousands, if not millions, of other people like me who are desperate to try whatever else is out there because I/we have trouble feeling comfortable in our noticeably imperfect skin.

I don't mean to be a smart aleck, it's just I'm a little bitter about my experience having spent thousands upon thousands of dollars with the best dermatologist around to watch my skin get progressively worse. And just so you know, I'm not normally one of those "loud" complainants. I've never written or spoken publicly about laser treatment and I'm not a regular contributor to forums in general (anonymous public forums can bring out the absolute worst in people).

The last thing I'll say is this: having viewed hundreds of other before and after pictures of folks who have tried laser leads me to only one reasonable conclusion... laser treatment is a desperate treatment for desperate people delivered by dermatologist who are excited to charge thousands of dollars so they can finally pay for the lease on their expensive/fancy "laser machines." You're playing Russian roulette with your skin--except 7 of the 8 slots in the metaphorical "gun" are loaded.

Those are my thoughts. I appreciate the dialogue on here, it gives me a vague sense of hope for some reason. The best advice I read on here in regards to acne scarring is learning to practice acceptance!

Acceptance that we live in an imperfect world with imperfect skin and that there's value and serenity in accepting the things we can't change. Besides, while

it's cliche, the real beauty and value in people is internal and can't be measured with unblemished skin. Having said that, acceptance my scars is a battle I still fight on a daily basis.

Didn't mean to get preachy... thanks y'all (I feel better.. ha).

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awells5, you didn't mention your treatment specifically, and I am quite specific. I only speak of Fraxel Re:pair, and only at high settings, and multiple treatments are required. If a person isn't prepared to go for broke they will be disappointed. One Re:pair, even at peak settings will not satisfy anyone. You must follow the regimen or stay home. Screw acceptance - go on the attack. You have to understand that the naysayers are not going all in. There is no instant gratification, and once you understand that the battle is half over. I have little reason to remain on the boards as my next step is plastic surgery for aging, but I am just trying to get my point across because I went through decades where there was no hope, and you guys have hope.

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awells5, you didn't mention your treatment specifically, and I am quite specific. I only speak of Fraxel Re:pair, and only at high settings, and multiple treatments are required. If a person isn't prepared to go for broke they will be disappointed. One Re:pair, even at peak settings will not satisfy anyone. You must follow the regimen or stay home. Screw acceptance - go on the attack. You have to understand that the naysayers are not going all in. There is no instant gratification, and once you understand that the battle is half over. I have little reason to remain on the boards as my next step is plastic surgery for aging, but I am just trying to get my point across because I went through decades where there was no hope, and you guys have hope.

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DudleyDoRight:

I had three separate sessions spread out over almost a year. After each session, the state of the skin only got worse.

Why would I continue to do something that costs thousands of dollars and makes the problem worse? I used Fraxel Re:Pair. Laser treatment is laser treatment regardless of the particulars of the laser. Anyone who tells you anything else is just giving you a sales pitch.

I think part of the problem was that I went "all in". I signed off on the dermatologist increasing the level of intensity before each and every session. Of course, he failed to give me proper warning that severe scarring can sometimes result from the treatment itself.

And I haven't just tried laser. I've literally tried every type of skin resurfacing treatment over the years other than having a skin graft.

I was never looking for instant gratification; I fully understand that improving skin takes time, patience, and realistic expectations.

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